Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box #22, New York, NY 10065, USA; Early Drug Development Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box #22, New York, NY 10065, USA.
Medical Physics, ProCure Proton Therapy Center, 103 Cedar Grove Lane, Somerset, NJ 08873, USA.
Surg Oncol Clin N Am. 2021 Jan;30(1):159-173. doi: 10.1016/j.soc.2020.08.006. Epub 2020 Oct 20.
Stereotactic ablative radiotherapy (SABR) commonly is used for small liver metastases. Modern conformal radiotherapy techniques, including 3-dimensional conformal radiotherapy and intensity-modulated radiation therapy, enable the safe delivery of SABR to small liver volumes. For larger tumors, the safe delivery of SABR can be challenging due to a more limited volume of healthy normal liver parenchyma and the proximity of the tumor to radiosensitive organs, such as the stomach, duodenum, and large intestine. Controlling respiratory motion, the use of image guidance, and increasing the number of radiation fractions sometimes are necessary for the safe delivery of SABR in these situations.
立体定向消融放疗（SABR）常用于治疗小肝癌转移灶。现代适形放疗技术，包括三维适形放疗和调强放疗，能够安全地为小肝体积提供 SABR。对于较大的肿瘤，由于健康正常肝实质的体积有限，以及肿瘤与胃、十二指肠和大肠等敏感器官的接近，安全地提供 SABR 可能具有挑战性。在这些情况下，控制呼吸运动、使用图像引导和增加放射剂量分次有时是安全提供 SABR 的必要条件。
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